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颅内动脉瘤血管内治疗围手术期脑损伤及炎症血清标志物分析:一项初步研究

Analysis of Serum Markers of Perioperative Brain Injury and Inflammation Associated with Endovascular Treatment of Intracranial Aneurysms: A Preliminary Study.

作者信息

Zimny Mikołaj, Paździora Piotr, Kocur Damian, Błaszczyk Bartłomiej, Gendosz de Carrillo Daria, Baron Jan, Jędrzejowska-Szypułka Halina, Rudnik Adam

机构信息

Department of Neurosurgery, Medical University of Silesia in Katowice, 40-055 Katowice, Poland.

Department of Physiology, Medical University of Silesia in Katowice, 40-055 Katowice, Poland.

出版信息

Brain Sci. 2023 Sep 11;13(9):1308. doi: 10.3390/brainsci13091308.

Abstract

Embolization is the preferred method for treating intracranial aneurysms due to its less invasive nature. However, recent findings suggest that even uncomplicated embolization may cause structural damage to the brain through ischemic or inflammatory mechanisms. This study aimed to find possible biomarkers of brain injury and inflammation in patients suffering from intracranial aneurysms who underwent endovascular treatment by measuring serological markers indicating brain damage. The study involved 26 patients who underwent uncomplicated intravascular stenting for unruptured intracranial aneurysms between January 2020 and December 2021. Blood samples were collected before the procedure, at 6-12 h, and at 24 h after the procedure. The following protein biomarkers levels were tested with ELISA: S100B, hNSE, TNF, hsCRP, FABP7, NFL, and GP39. Statistical analysis of the results revealed significant increases in serum levels for the four biomarkers: FABP7-before 0.25 (ng/mL) vs. 6-12 h 0.26 ( = 0.012) and vs. 24 h 0.27 ( < 0.001); GP39-before 0.03 (pg/mL) vs. 6-12 h 0.64 ( = 0.011) and vs. 24 h 0.57 ( = 0.001); hsCRP-before 1.65 (μg/mL) vs. 24 h 4.17 ( = 0.037); NFL-before 0.01 (pg/mL) vs. 6-12 h 3.99 ( = 0.004) and vs. 24 h 1.86 ( = 0.033). These biomarkers are recognized as potential indicators of neurovascular damage and should be monitored in clinical settings. Consequently, serum levels of NFL, GP39, hsCRP, and FABP7 measured before and 24 h after endovascular procedures can serve as important markers for assessing brain damage and indicate avenues for further research on biomarkers of neurovascular injury.

摘要

由于侵入性较小,栓塞术是治疗颅内动脉瘤的首选方法。然而,最近的研究结果表明,即使是无并发症的栓塞术也可能通过缺血或炎症机制对大脑造成结构性损伤。本研究旨在通过测量表明脑损伤的血清学标志物,寻找接受血管内治疗的颅内动脉瘤患者脑损伤和炎症的可能生物标志物。该研究纳入了26例在2020年1月至2021年12月期间因未破裂颅内动脉瘤接受无并发症血管内支架置入术的患者。在手术前、术后6 - 12小时和术后24小时采集血样。采用酶联免疫吸附测定法(ELISA)检测以下蛋白质生物标志物水平:S100B、人神经元特异性烯醇化酶(hNSE)、肿瘤坏死因子(TNF)、超敏C反应蛋白(hsCRP)、脂肪酸结合蛋白7(FABP7)、神经丝轻链(NFL)和糖蛋白39(GP39)。结果的统计分析显示,四种生物标志物的血清水平显著升高:FABP7——术前0.25(ng/mL),术后6 - 12小时为0.26(P = 0.012),术后24小时为0.27(P < 0.001);GP39——术前0.03(pg/mL),术后6 - 12小时为0.64(P = 0.011),术后24小时为0.57(P = 0.001);hsCRP——术前1.65(μg/mL),术后24小时为4.17(P = 0.037);NFL——术前0.01(pg/mL),术后6 - 12小时为3.99(P = 0.004),术后24小时为1.86(P = 0.033)。这些生物标志物被认为是神经血管损伤的潜在指标,在临床环境中应进行监测。因此,血管内手术后24小时前后测量的NFL、GP39、hsCRP和FABP7的血清水平可作为评估脑损伤的重要标志物,并为神经血管损伤生物标志物的进一步研究指明方向。

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